Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.0 X 40 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682945
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 40 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682945
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 4.0 X 42 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682946
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 4.0 X 42 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682946
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 44 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682947
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 44 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682947
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 4.0 X 46 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682948
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 46 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682948
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 4.0 X 48 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682949
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 4.0 X 48 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682949
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0X 50

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270686746
Hospital Revenue Code	278
Min. Negotiated Rate	$170.25
Max. Negotiated Rate	$274.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25

SCREW 4.0X 50

Facility

$1,135.00

Service Code	HCPCS C1713
Hospital Charge Code	270686746
Hospital Revenue Code	278
Min. Negotiated Rate	$32.23
Max. Negotiated Rate	$567.50
Rate for Payer: Aetna Commercial	$431.30
Rate for Payer: Aetna Medicare Advantage	$340.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$289.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$227.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$289.43
Rate for Payer: Cigna Commercial	$567.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$274.67
Rate for Payer: Qualcare PPO/HMO/WC	$170.25
Rate for Payer: UnitedHealthcare Community & State	$35.87
Rate for Payer: Wellpoint Medicaid Managed Care	$32.23

SCREW 4.0 X 50 MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691651
Hospital Revenue Code	278
Min. Negotiated Rate	$284.70
Max. Negotiated Rate	$459.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70

SCREW 4.0 X 50 MM

Facility

$1,898.00

Service Code	HCPCS C1713
Hospital Charge Code	270691651
Hospital Revenue Code	278
Min. Negotiated Rate	$53.90
Max. Negotiated Rate	$949.00
Rate for Payer: Aetna Commercial	$721.24
Rate for Payer: Aetna Medicare Advantage	$569.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$483.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$379.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$483.99
Rate for Payer: Cigna Commercial	$949.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.32
Rate for Payer: Qualcare PPO/HMO/WC	$284.70
Rate for Payer: UnitedHealthcare Community & State	$59.98
Rate for Payer: Wellpoint Medicaid Managed Care	$53.90

SCREW 4.0 X 50 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682951
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 4.0 X 50 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682951
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 55 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682952
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 55 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682952
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 4.0 X 60 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682953
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

SCREW 4.0 X 60 mm CANNULATED

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270682953
Hospital Revenue Code	278
Min. Negotiated Rate	$23.43
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$23.43

SCREW 42 MM LGTH

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691767
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$574.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

SCREW 42 MM LGTH

Facility

$2,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270691767
Hospital Revenue Code	278
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$574.75
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Community & State	$75.05
Rate for Payer: Wellpoint Medicaid Managed Care	$67.45

SCREW 4.3

Facility

$589.00

Hospital Charge Code	270335967
Hospital Revenue Code	278
Min. Negotiated Rate	$16.73
Max. Negotiated Rate	$294.50
Rate for Payer: Aetna Commercial	$223.82
Rate for Payer: Aetna Medicare Advantage	$176.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.19
Rate for Payer: Cigna Commercial	$294.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.54
Rate for Payer: Qualcare PPO/HMO/WC	$88.35
Rate for Payer: UnitedHealthcare Community & State	$18.61
Rate for Payer: Wellpoint Medicaid Managed Care	$16.73

SCREW 4.3

Facility

$589.00

Hospital Charge Code	270335967
Hospital Revenue Code	278
Min. Negotiated Rate	$88.35
Max. Negotiated Rate	$142.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.54
Rate for Payer: Qualcare PPO/HMO/WC	$88.35

SCREW 4.35MM X 45 MM

Facility

$7,678.35

Service Code	HCPCS C1713
Hospital Charge Code	270691005
Hospital Revenue Code	278
Min. Negotiated Rate	$1,151.75
Max. Negotiated Rate	$1,858.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,535.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,858.16
Rate for Payer: Qualcare PPO/HMO/WC	$1,151.75

Know your out-of-pocket cost for care.

All Charges